key: cord-340279-bq5owwot
authors: Espíndola, Otávio de Melo; Siqueira, Marilda; Soares, Cristiane Nascimento; Lima, Marco Antonio Sales Dantas de; Leite, Ana Claudia Celestino Bezerra; Araujo, Abelardo Queiroz Campos; Brandão, Carlos Otávio; Silva, Marcus Tulius Teixeira
title: Patients with COVID-19 and neurological manifestations show undetectable SARS-CoV-2 RNA levels in the cerebrospinal fluid
date: 2020-06-04
journal: Int J Infect Dis
DOI: 10.1016/j.ijid.2020.05.123
sha: 
doc_id: 340279
cord_uid: bq5owwot

Abstract We report that patients with COVID-19 displaying distinct neurological disorders have undetectable or extremely low levels of SARS-CoV-2 RNA in the cerebrospinal fluid, indicating that viral clearance precede the neurological involvement. This finding points to the need for the development of more sensitive molecular tests and the investigation of other neurotropic pathogens to exclude concurrent neuroinfection.

1 1 Highlights 2

• SARS-CoV-2 RNA is mainly undetectable in the cerebrospinal fluid. 3

• SARS-CoV-2 clearance in the cerebrospinal fluid may precede the neurological involvement. 4

• Common neuropathogens should be investigated in the CSF of COVID-19 patients. (Table 1) . CSF analysis showed normal to mild elevated protein levels, and 86 pleocytosis was particularly observed in the cases of meningoencephalitis (Table 2) . Indeed, CNS 87 infiltrate was predominantly constituted by mononuclear cells, which is compatible with viral infection 88 (Table 2) (Table 1) 

Status of SARS-CoV-2 in 127 cerebrospinal fluid of patients with COVID-19 and stroke

Guillain-Barré syndrome related 130 to COVID-19 infection

Two patients with 132 acute meningo-encephalitis concomitant to SARS-CoV-2 infection

Management of Viral Central 134 Nervous System Infections: A Primer for Clinicians

Guillain-Barré syndrome as 137 a complication of SARS-CoV-2 infection

Plasmapheresis treatment in COVID-19-139 related autoimmune meningoencephalitis: Case series

Neurologic Features in Severe 141 SARS-CoV-2 Infection


